Prediabetes diet: How to help prevent progression to type 2 diabetes

From health.harvard.edu

When it comes to this common condition, food really is one of the best medicines

Summary: A prediabetes diet is an eating plan that may help prevent prediabetes from turning into full-blown diabetes. Many different foods can fit into this style of eating, including fruits and vegetables, beans and legumes, lean proteins, whole grains, and healthy fats. While no foods are off-limits, prediabetes diets generally are low in sugary foods, refined carbohydrates, fast foods, fried foods, and alcohol.

There’s no one prediabetes diet. But following healthy eating habits can help you lower your blood sugar and reduce your risk for developing full-blown diabetes.

“It’s not about single foods or 'super’ foods but the overall eating pattern. Focusing on the average of what you eat also allows for small treats and occasionally dining out,” says Nancy Oliveira, a dietitian, certified diabetes care and education specialist, and manager of the Nutrition and Wellness Service at Harvard-affiliated Brigham and Women’s Hospital.

Here’s how you can update your menu to protect your health.

What is prediabetes?

Prediabetes is a condition in which your blood glucose (sugar) is higher than it should be — but not high enough to count as diabetes. With prediabetes and type 2 diabetes (which accounts for 90% to 95% of diabetes cases in the U.S.), high blood glucose occurs when your body is unable to use insulin efficiently. Over time, your body becomes unable to produce enough insulin. Insulin is the hormone that helps your body move blood sugar from your bloodstream into your cells for energy.

An optimal fasting blood glucose level is usually 70 to 99 milligrams per decilitre (mg/dL). When you have prediabetes, your fasting blood glucose is 100 to 125 mg/dL. (A fasting blood sugar of 126 mg/dL or higher indicates diabetes.)

Prediabetes can turn into type 2 diabetes when it isn’t managed. That can lead to long-term problems like heart disease, nerve damage, and kidney disease.

How can a prediabetes diet help lower blood sugar?

Lifestyle changes like eating a healthy diet and being more active are first-line treatments for prediabetes. Both of these things can bring your blood sugar levels closer to normal. That can slow or stop prediabetes from turning into diabetes.

A healthy eating pattern and attention to portion size can also help you lose excess weight. That in turn allows your body to use insulin more efficiently, making it easier for your cells to take up glucose from your bloodstream — bringing down your blood glucose levels.

It takes only a small amount of weight loss to reap the benefits. Studies show that losing around 7% of your body weight may be enough to keep diabetes at bay. For a 160-pound person, that’s a loss of around 11 pounds.

That said, diet changes can still make a difference even if you don’t lose much weight. “We see patients who might shed only 2 to 3 pounds despite following a diabetes-friendly diet, but their blood sugar and blood cholesterol still improve,” says Oliveira.

Best foods to eat for prediabetes

                                                                                              Image: © fcafotodigital/Getty Images

Many different foods can help control or lower your blood sugar when you have prediabetes. Consider adding these wholesome picks (in reasonable portion sizes) to your plate:

• non-starchy vegetables: asparagus, beets, broccoli, brussels sprouts, carrots, cauliflower, cucumbers, eggplant, leafy greens, mushrooms, peppers, summer squash, tomatoes, and zucchini
• lean protein: beans, eggs, fish and shellfish, lean poultry, lean red meat (like sirloin or flank steak), lentils, reduced-fat cheese, and soy foods (like tofu and tempeh)
• fresh fruit: apples, apricots, bananas, berries, melon, oranges, peaches, and pears
• whole grains and starchy vegetables: whole-wheat bread, whole-wheat pasta, brown rice, oatmeal, quinoa, sweet potatoes, skin-on white potatoes, winter squash, peas, and corn
• low-fat dairy: low-fat milk, plain Greek yogurt, and cottage cheese
• healthy fats: olive oil and olives, avocado, nuts, and seeds
• water and unsweetened drinks.

Complex carbs vs. refined carbs: What’s the difference?

The type of carbohydrates you eat can have a big effect on your blood sugar. Choosing complex or minimally refined carbs can make it easier to manage your prediabetes.

When you have a food or drink that contains carbohydrates, your body breaks the carbs down into glucose. This enters your bloodstream, raising your blood glucose levels. In response, your pancreas releases insulin to move the glucose into your cells, where it can be used for energy.

Refined or simple carbs get broken down into glucose quickly. They cause a rapid spike in blood glucose levels, which can make it harder to control your prediabetes.

Foods high in refined carbs include white bread, white pasta, white rice, soda, fruit juice, baked goods, candy, and other foods high in added sugars. “If you’re consuming these items daily and at most meals and not moving much, your pancreas will work overtime to make insulin, which can stress it so much it may eventually not work as well, leading to diabetes,” Oliveira explains.

Complex carbohydrates help control your blood sugar. They contain fibre, so they’re broken down at a slower rate. As a result, they have less of an effect on your blood glucose. Foods high in complex carbs include whole grains such as whole-wheat bread, whole-wheat pasta, brown rice, oatmeal, and quinoa, as well as beans and other legumes, and starchy vegetables (like corn, sweet potatoes, and peas).

Food and drinks to limit with prediabetes

Limiting foods and drinks with refined carbs and unhealthy fats, both of which can make your cells less responsive to insulin, can make it easier to manage your blood glucose. Over time, that may help you avoid diabetes.

Try to have the following less often:

• sugary foods and snack foods such as cookies, candy, ice cream, sweetened cereal, packaged granola bars, chips, pretzels, and canned fruit with added sugar
• sugary drinks such as soda, fruit juice, sweet tea, sweetened coffee and tea drinks, sports drinks, and energy drinks
• refined carbohydrates such as white bread, white pasta, white rice, and white tortillas
• fast food and fried foods high in saturated fat
• excess alcohol.

Can you reverse prediabetes with diet and lifestyle changes?

Healthy eating patterns and regular exercise may be able to bring your fasting blood glucose back within normal range. That can effectively reverse your prediabetes.

The key is choosing lifestyle changes you can stick with. That way you can maintain your well-earned benefits long-term. Prediabetes can return if you go back to your old eating and activity habits.

Sample prediabetes diet plan and meal ideas

The best prediabetes eating plan is one that you enjoy and that fits with your lifestyle. Consider choosing from options like the Mediterranean diet, the DASH diet, or another plant-based or low-carbohydrate diet. These have all been shown to prevent prediabetes progression — and can be customized to work for you.

You can find helpful meal planning guides and sample recipes at the American Diabetes Association’s Diabetes Food Hub. Many of these meals use the Diabetes Plate method, in which you divide your plate into three balanced sections:

• non-starchy vegetables on 50% of your plate
• complex carbohydrates on 25% of your plate
• lean protein on 25% of your plate.

Here are some examples of combinations that you might prepare under the Diabetes Plate method:

• turkey meatloaf with a mixed green salad and quinoa
• baked salmon with sauteed garlicky greens and a sweet potato
• tofu and bell pepper stir-fry with brown rice
• roasted skinless chicken with air-fried baby potatoes and cauliflower florets
• lentil soup with kale, diced tomatoes, and chopped sweet potato.

How to lower A1c and help prevent diabetes long-term

You can see the effect of lifestyle changes over time by looking at your haemoglobin A1c levels. This blood measurement reflects your average blood sugar over the past three months. Getting this number close to or within the normal range can reduce your diabetes risk.

Resist the urge to make lots of big changes at once. Smaller shifts in your diet and activity level may be easier to maintain. And they can add up to healthier blood sugar long-term.

Talk with your doctor to decide on a plan for monitoring your blood sugar. The American Diabetes Association recommends checking your A1c annually, but depending on your risk factors and progression of prediabetes, your doctor may advise rechecking it sooner.

https://www.health.harvard.edu/diet-and-nutrition/prediabetes-diet-how-to-help-prevent-progression-to-diabetes

Why You Should Be Lifting Weights if You Have Type 2 Diabetes

From everydayhealth.com 

While regular aerobic exercise can help you keep your blood sugar levels in check and boost your overall health, people with diabetes can benefit from regular weight lifting, or strength training, as well. In fact, the American Diabetes Association (ADA) recommends strength training 2–3 times per week in addition to performing at least 150 minutes of moderate-intensity physical activity (or 75 minutes of vigorous-intensity exercise).

Before starting a new exercise routine, talk with your doctor about any special considerations you need to make. Complications of type 2 diabetes, such as heart disease, peripheral neuropathy, diabetic retinopathy, blood pressure issues, and osteoporosis, can influence which forms of strength training are healthiest for you.

How Lifting Weights May Make Managing Type 2 Diabetes Easier

Diabetes is marked by the body’s inability to process glucose and use insulin efficiently, but strength training can help with these issues in various ways.

Burns Up Blood Sugar

Strength training relies primarily on the body’s glycolytic, or glucose-using, metabolic system for energy. “As we go through a strength training workout, we use stored muscle glycogen for fuel,” says Nick Occhipinti, CSCS, an exercise physiologist based in Red Bank, New Jersey. “Once this stored muscle glycogen runs out, we start to mobilize extra glycogen from the liver and from the blood. This [process] helps directly decrease blood glucose as well as deplete stored muscle and liver glycogen stores, giving blood glucose a place to go next time you eat.”

Improves Glucose Storage

Your muscles serve as storage facilities for consumed sugar and carbohydrates. “Trained muscle has a higher capacity to store blood glucose in the form of glycogen, aiding in lowering blood glucose,” says Occhipinti. The result: Lowered blood sugar levels and easier glucose management.

Spurs Weight Loss

Apart from burning calories during your workouts, strength training promotes fat loss by increasing levels of lean muscle mass. “Muscle is one of the few metabolically active tissues in the body at total rest,” says Occhipinti. “This means that even as we sit around and watch football or sit at a desk and work, the muscle we have on our body is serving to burn calories.”

In people carrying extra weight, losing 5 to 10 percent of your body weight can improve A1C scores, the 2- to 3-month average of blood sugar levels.

Targets Harmful Belly Fat

Abdominal fat (also called visceral fat) exacerbates insulin resistance and complicates blood sugar management, says Occhipinti, explaining that, in addition to storing energy, visceral fat cells produce chemicals and hormones that inhibit the body’s effective use of insulin. Fortunately, resistance training combined with moderate endurance training and a restrictive diet can be effective at reducing visceral fat levels.

6 Tips for Strength Training With Diabetes

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The ADA suggests people with type 2 diabetes engage in 2–3 strength training sessions per week on non-consecutive days. Here are some strategies to help you get the most benefits from your strength training sessions.

1. Talk to Your Healthcare Team

As with any exercise program, check with your healthcare team before starting a weight training regimen, making a point to discuss your blood sugar management specifically.

“People don’t typically associate strength training with low blood sugar, but some patients will have significant impacts on blood sugar with strength training,” says Wilson. Your doctor may recommend testing your blood sugar level before, during, and after exercise, as well as eating carbohydrates around workout time to prevent or address hypoglycaemia, she adds.

2. Ask for Help

“To gain more health benefits from physical activity programs, participation in supervised training is recommended over non-supervised programs,” says Wilson. For guidance, consider working out with a certified trainer or joining a weight training class, both of which are available in person and virtually.

3. Focus on the Body’s Largest Muscle Groups

Occhipinti recommends working on your gluteal muscles, hamstrings, quadriceps, latissimus dorsi, trapezius, and chest muscles. Some of the best strength exercises that target these muscle groups are compound, multijoint movements such as squats, lunges, deadlifts, hamstring curls, rows, lat pull-downs, chest presses, and push-ups, he says.

4. Follow a Plan

Mapping out what you want your workouts to look like can help you make and keep a routine, says Audra Wilson, RD, CSCS, a bariatric dietitian and strength and conditioning specialist at the Northwestern Medicine Metabolic Health and Surgical Weight Loss Center at Delnor Hospital in Geneva, Illinois.

If you plan to strength train two or three times per week, she says you’re better off making all of your workouts total body workouts. However, if your strength training is going to be more frequent, such as four or five days per week, alternating between upper body and lower body workouts, or push and pull workouts, can help ensure that each muscle group still gets the recovery time it needs.

Wilson recommends trying new variations of your favourite exercise or altering your number of sets or reps every 8–12 weeks to keep your workouts — and results — progressing.

5. Prioritize Recovery

Giving yourself one (if not two) days in between working a particular muscle group can allow it time to repair while still training it with sufficient frequency to adapt and grow, says Wilson. Great recovery day options include foam rolling, stretching, and low-intensity cardio like walking or cycling.

6. Consider Multiple Tools

Barbells, dumbbells, and weight machines can be useful strength training tools, but they aren’t mandatory, says Occhipinti. Resistance bands, filled duffle bags, and other household items are also effective in loading the muscles and are particularly great for helping you log more at-home workouts.

How Strength Training Helps Protect Against Diabetes Complications

By improving insulin health and lowering high blood sugar levels, strength training helps guard against some of the complications of type 2 diabetes. But it takes on diabetes complications in other ways, too.

Improves Heart Health

Type 2 diabetes is a leading risk factor in the development of heart disease. Fortunately, strength training increases levels of HDL cholesterol in the body while reducing LDL cholesterol levels, says Occhipinti. It also helps lower high blood pressure (hypertension).

Boosts Bone Density

While people with type 2 diabetes often have normal bone mineral density scores, they are at a heightened risk of bone fracture. Fortunately, weight-bearing strength training, especially performed from a standing position, helps build strength in the bones of the legs, spine, and hips, reducing the risk of bone breaks, says Wilson.

Prevents Age-Related Muscle Loss

Type 2 diabetes is an independent risk factor for accelerated declines in muscle strength. Research links severe age-related muscle degradation called sarcopenia to loss of physical function and increased risk of falls, hospitalization, and early death.

Conversely, building muscle through strength training directly combats this muscle loss that can occur through the decades.

Reduces the Risk of Peripheral Neuropathy and Vision Loss

“When you have chronically high blood sugar, glucose molecules start attaching themselves to everything, including your red blood cells, preventing healthy blood flow in many places in the body where you have very small blood vessels,” says Occhipinti.

It just so happens that the eyes and nerves of the hands and feet have these small vessels. When these areas don’t get the blood flow they need, peripheral neuropathy and diabetic retinopathy can occur. Strength training improves blood flow to reduce the risk of these complications, says Occhipinti.

The Takeaway

• Adults with type 2 diabetes should strength train 2–3 times per week, combining weight lifting with aerobic exercise for optimal blood sugar control.
• Strength training supports diabetes management by directly lowering blood glucose for energy, increasing the muscles' capacity to store glucose, promoting lean muscle mass, and targeting visceral belly fat.
• When starting a weightlifting regimen, individuals should first consult their healthcare team, focus on large muscle groups, use various tools like resistance bands and free weights, and prioritize adequate recovery time between sessions.
• Beyond managing blood sugar, lifting weights regularly helps protect against serious diabetes complications by improving cardiovascular health, boosting bone density to reduce fracture risks, combating age-related muscle loss, and improving blood flow to protect nerve and vision health.
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• https://www.everydayhealth.com/diabetes/why-to-lift-weights-with-type-2-diabetes/

7 Sneaky Signs Your Blood Sugar Is Too High, According to Dietitians

From eatingwell.com

High blood sugar isn't always obvious—these are the warning signs dietitians want you to know 

KEY POINTS

• High blood sugar can develop gradually and may not cause noticeable symptoms early on.
• Symptoms like excessive thirst, frequent urination and blurry vision may signal issues.
• Lifestyle changes, like a balanced diet, can help manage or prevent high blood sugar.

The signs and symptoms of elevated blood sugar are easy to overlook, mistake or miss altogether. This is especially true for type 2 diabetes, which can go undiagnosed for many years. "Undiagnosed diabetes is more common than many people think," says Mary Ellen Phipps, MPH, RDN, LD. "According to the CDC, 11 million adults meet the diagnostic criteria for diabetes, but don't know they have it."

Why are so many people unaware? "Many people with mild to moderately high blood sugar, especially in prediabetes or early type 2 diabetes, may have no noticeable symptoms at all," says Jackie Topol, M.S., RD, CDN. Plus, high blood sugar tends to develop gradually, and in its early stages, symptoms may be subtle or absent altogether.

The good news is that early intervention can make a difference, says Phipps. Whether you have a family history of high blood sugar or diabetes or just want to be proactive about your health, here are some signs of high blood sugar to watch for.

                                                                                           Credit: Getty Images. EatingWell design

1. You're Thirsty All the Time

Is your thirst unquenchable? Are you making more frequent trips to the bathroom? When blood sugar levels are high, these symptoms often go hand in hand.

"Excess sugar in the blood results in the kidneys working harder to get rid of it," says Maria Elena Fraga, RD, CDCES, CDN. "The kidneys draw in water from your tissues to dilute the glucose so it can be excreted via the urine, resulting in more frequent trips to the bathroom."

As your body loses water and electrolytes through increased urination, thirst can ramp up, causing you to drink more fluids. If you're drinking sugary beverages such as juice, sports drinks or soda, that can cause blood sugar levels to climb even higher. 

2. You're Hungry All the Time

"Your body converts the food you eat into glucose, later used by your cells for energy," says Fraga. However, sometimes, that glucose is unable to enter your cells. This can happen if your body doesn't produce enough insulin, the hormone that helps move glucose into cells, or if the insulin it produces isn't used efficiently.

The result? "The inability to use glucose causes a lack of energy, which can make you hungrier than usual," says Fraga. 

In some cases, excessive hunger accompanied by weight loss can be a sign of diabetes, especially type 1 diabetes. If you're eating enough but still feel constantly hungry and are also losing weight, it's important to seek evaluation from a health care professional.

3. Your Vision Is Blurry 

High blood sugar can affect the small blood vessels in the eyes, resulting in blurry vision that may come and go, sometimes long before a diabetes diagnosis is made. Over time, this can damage the retina of your eye, resulting in a condition known as diabetic retinopathy. In fact, the American Diabetes Association recommends that all people diagnosed with type 2 diabetes receive a dilated eye exam shortly after diagnosis.

4. You're Always Tired

Remember how your cells need glucose for fuel? A lack of insulin, insulin resistance or a combination of both can prevent cells from taking in glucose from the bloodstream to use for energy. Without the proper fuel, you can feel very tired and fatigued. 

5. You Keep Getting Urinary Tract Infections

Research suggests that nearly 40% of people living with diabetes experience urinary tract infections (UTIs).  That's because the body works to get rid of excess blood sugar by increasing urine output. While that may help lower sugar in the bloodstream, it can also lead to increased bacterial growth that can cause UTIs, says Fraga.

6. You Develop Dark Spots and Skin Tags

Dark velvety patches in skin creases—such as the neck, armpits, fingers and groin—may be a sign of a diabetes-related condition called acanthosis nigricans.  It is caused by high insulin levels, "which can be an early sign of prediabetes, diabetes [or] insulin resistance," says Fraga.

But these aren't the only skin changes linked to high blood sugar. Skin tags, dermatitis, bacterial and fungal infections and dry, itchy skin can also be subtle signs of elevated blood sugar.

7. You Have Other Unexplained Symptoms 

Not everyone will experience the same symptoms, and some are more common than others. "Hair loss and dry skin, nausea, wounds that won't heal, tingling in the fingers and toes, and dry mouth are other symptoms of high blood sugar," says Phipps. Sexual health issues may also occur, including decreased libido or erectile dysfunction in men and vaginal dryness in women.

Strategies for Managing High Blood Sugar

Elevated blood sugar occurs when sugar in the form of glucose accumulates in your blood, says Topol. We get glucose from carbohydrate-containing foods such as bread, rice, pasta and fruits. "After digestion, glucose enters the blood and is used by the body for energy," she explains. "Insulin, a hormone made by the pancreas, assists in moving glucose from the blood into the cells. If a person doesn't make insulin or can't use it properly (as in insulin resistance), sugar stays in the bloodstream instead of being used for energy."

Managing blood sugar often comes down to consistent lifestyle habits that support how your body uses glucose. While medical care is essential for diagnosis and treatment, certain daily behaviours can help improve blood sugar control over time.

• Stay physically active. Regular exercise can improve insulin sensitivity, making it easier for cells to use glucose for energy. Even moderate movement, like walking, can make a difference.
• Focus on balanced meals. Eating a mix of fibre-rich carbohydrates, lean protein and healthy fats can help prevent blood sugar spikes and promote steadier energy levels.
• Maintain a healthy weight. For some people, even modest weight loss can improve insulin function and blood sugar control.
• Avoid smoking. Smoking is linked to insulin resistance and can worsen blood sugar regulation over time.
• Manage other health conditions. Keeping conditions like high blood pressure under control can support overall metabolic health.

While lifestyle changes can make a meaningful impact, they're not a substitute for medical care. In some cases, these habits may even help delay or improve type 2 diabetes. If you're concerned about your blood sugar, a simple blood test from a health care provider can help guide next steps.

Our Expert Take

Elevated blood sugar is not always accompanied by symptoms. However, there are some sneaky signs to be aware of. If you have high blood sugar, targeted lifestyle changes—like a blood sugar-friendly diet, exercise and weight loss, if indicated—can make a meaningful difference. The first and most impactful change you can make is to assess your eating habits. If you need assistance planning meals specific to your food preferences and culture or discovering which foods work best for your body, consider meeting with a registered dietitian. These nutrition experts can provide personalized guidance on the best ways to structure your meals and snacks for better blood sugar and overall health. 

https://www.eatingwell.com/sneaky-signs-your-blood-sugar-is-too-high-11981073